Editorial - Pharmacist Vigilance Crucial To Public Safety

Posted on
10/11/04

by Joel Zive, PharmD

Earlier this year, I wrote about how pharmacists need to take a proactive role in doing more counseling for patients. In addition to doing the ?right thing? for the patient and profession, this would support an argument to have pharmacists receive payment for cognitive services under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Since then, I have thought of another equally important reason for intensive patient counseling: community safety. In parts of New York City, crystal metamphetamine (street names Tina and Crank) is decimating certain populations. Crystal metamphetamine is also a problem in other parts of the country. Last summer, I attended a lecture on this burgeoning drug problem. According to the lecturer, a psychiatrist who treats these patients, the drug makes you feel euphoric. But the user pays a terrible price in return; alteration of brain chemistry, addiction and a total destruction of someone?s life are realistic outcomes.

You might be thinking, ?Joel, we are all pharmacists ? why give us the \'drugs are bad\' lecture?? The reason is vigilance. Also discussed in this lecture were the resources people had in synthesizing these drugs. In fact, the lecturer gave the audience websites in which one could follow STEP BY STEP INSTRUCTIONS ON HOW TO MAKE CRYSTAL METH! The websites were actually printed in the New York Times as part of an article on this problem. I went to the website and found the area regarding drug synthesis. If you have a rudimentary knowledge of chemistry, you can create your very own crystal meth lab.

Here?s where pharmacists come into the picture. One of the substrates in making this product is pseudoephedrine. You need a lot of pseudoephedrine to make crystal meth. If someone came into your pharmacy or asked you how to obtain 10, 20, 30 boxes of pseudoephedrine ? be suspicious. If you do not feel comfortable confronting the patient, contact local law enforcement officials. In fact, according to the lecturer of this talk, the state of California has placed restrictions on selling pseudoephrine. Pharmacists are the most accessible healthcare providers; in addition, we can also be an early warning system for dangers to public health.

Also attending this lecture was a man who has worked in urban health for 20 plus years. He said it takes at least 5 years for state and federal government to gather resources to fight a public health problem ? look how long it took government to address HIV and AIDS. By being vigilant, we can address these problems before they take a firm hold in our communities. If a public health problem is firmly entrenched, at worst, we can support the argument to spend tax dollars to fight the problem.

I worked in New York City during the crack epidemic. I saw first-hand how crack destroys neighborhoods and families. Crystal meth has the same potential for destruction. Please do not let this happen in your community.